Good Health Outside the Doctor’s Office Closing the health equity gap with playgrounds and produce

It’s a perfect day in Pensacola, Florida, and the Blue Angels, based at the nearby air station, are doing their weekly exercises over the Gulf. A drive inland along Palafox Street starts at the upscale town square and passes freshly painted colonials, esthetic surgery clinics, boutiques, and banks. But all this changes at Cervantes Avenue: Suddenly the trappings of wealth disappear, replaced by foreclosure signs, dialysis centers, thrift stores, and check-cashing outlets.
This is still Pensacola, but not the one that snowbirds and tourists see. As Sandra Donaldson, a native of this second Pensacola, explains, “There is an invisible divide between here and there.”

>Daphne Miller is a practicing family physician, professor, and journalist who examines the links between human health and the health of the natural and built environment. She teaches at the University of California, San Francisco. This article was funded by the Prevention Institute, supported by a grant from The Kresge Foundation. A special thanks to Tiffany Netters, Alex Priebe, and Amy Pruim at Louisiana Public Health Institute for their help with this story.

Blocks later, I park in front of`a professional brick building, not unlike community clinics that I have worked in during my medical career. Inside, I am surprised to find that Chandra Smiley, executive director for the Escambia Community Clinic network, is working right next to the waiting area busy with coughing patients, beeping toys, and CNN blaring on a wall-mounted TV.

“Being this close to the patients helps me understand what’s really going on,” Smiley says. “I don’t want this to be just another community clinic; I want it to be the community’s clinic.” Her emphasis on the possessive might at first pass seem like an unimportant distinction, but, in fact, it represents radical thinking. Traditionally, safety net clinics like Escambia offer medical services to low-income and underserved patients who access their facilities, but Smiley and her team are trying to expand this role by improving the quality of life in the surrounding community. “Our goal,” Smiley says, “is to help fix things that get us sick in the first place, like substandard housing, unhealthy food, and lack of opportunity.” Escambia, along with four other clinic sites that dot the Gulf Coast, is part of a two-year health care experiment called the Community Centered Health Home (CCHH) demonstration project, which is funded through the Deepwater Horizon Medical Benefits Class Action Settlement, a result of the 2010 BP oil spill off the coast of Louisiana. If it succeeds, this experiment could help redefine the role of community clinics in the United States.

The idea that health care can be an engine for community change is not entirely new. In the mid-1960s, physician Jack Geiger opened clinics in the impoverished rural South, with a mission to go beyond treating patients to address the social determinants of health. Instead of simply recommending better diets, he helped his patients obtain tractors, seeds, and farmland so that they could grow healthful food. While Geiger is credited with starting the first community clinics, his more radical idea to use organized medicine to address the root causes of illness never caught on.

Recently, Geiger’s ideas are getting more attention. The Affordable Care Act, also known as Obamacare, has created a series of mandates and incentives to cut health care costs while expanding health care access and improving quality. Since the United States spends more than twice per capita on health care as countries like Germany, France, and Switzerland but lags far behind in health outcomes, most would agree that these are worthy goals. There is less agreement on how to accomplish them.

Initially, programs promoted by the ACA prioritized expanding insurance coverage and retooling medical services, but it has since become evident these efforts are necessary but not sufficient to change health outcomes for vulnerable communities — hence more outside-the-box approaches such as the one being tested by the Escambia Clinic. If Obamacare in its entirety is repealed, these innovative efforts could also fall by the wayside.

Two days before visiting Pensacola, I met Eric Baumgartner at his office in the Louisiana Public Health Institute in New Orleans. Baumgartner, a pediatrician and public health expert, is directing the Gulf Coast CCHH demonstration project.

Early in his pediatric residency, Baumgartner became frustrated by the fact that much of the illness he was seeing in his young patients was a product of their social situation and their physical surroundings.

“I decided that I wanted to understand interaction between biology and nurturing environment,” he says.

He became an early champion of what is sometimes referred to as the ZIP code effect, a reference to a series of studies showing that one’s address has a far greater impact on health and life expectancy than genetic risk or the quality or accessibility of medical treatment. Baumgartner also contends that individual behaviors, such as diet and exercise patterns, are a product of ZIP code rather than willpower, which may explain why most public health education campaigns have little impact on health outcomes.

I asked Baumgartner to describe what takes place in a Community Centered Health Home.

“It’s more a state of mind than a set of activities,” he says. “And the clinic, which is typically a service delivery organization, has a responsibility to use its position of influence within the community to act as partner in improving the social, environmental, and economic conditions that determine health.” He describes clinic patients of a CCHH as not just representing themselves but being “sentinels for the community in which they reside.”

Ashley Parish’s children romp around on the playground at C.A. Weis Elementary School. YES! photo by Annabelle Rose Photography

Later, at C.A. Weis Elementary School in Pensacola’s Pinecrest neighborhood, first-graders stream out the double doors and settle on the brand-new playground structure like a flock of migrating birds. It’s a generic-looking playset, one that could be found in any public school around the country. And yet, as I hear how it came to be, I understand that this plastic-and-metal structure is a catalyst for improving neighborhood health.

When it comes to almost every health indicator, the Englewood area (ZIP code 32505), where many Escambia clinic patients reside, has been dealt a crummy hand. Within the context of greater Pensacola, this zone has unusually high rates of violent crime, unemployment, housing foreclosures, drug abuse, and preterm births. Recently the Urban Institute gave it a high inequity score, meaning that it is a place where the poorest 10 percent and richest 10 percent of Americans live in extreme proximity. Another report identified Pensacola as one of a few cities (along with Tampa and Knoxville, Tennessee) where the life expectancy gap between the richest and poorest has increased in the past decade. When Chandra Smiley learned that her clinic had been chosen to be a part of the CCHH experiment, she felt more anxious than enthusiastic. How could she and her colleagues possibly make a difference in the face of such daunting socioeconomic problems? She shared her misgivings with Baumgartner during a CCHH orientation meeting, and he gave her a strategy that was simple yet actionable.

“This is our serenity prayer,” Smiley recalls him saying. “You don’t have to solve all the problems. You just have to get involved.”

Smiley got involved.

She and Sandra Donaldson, director of special programs in the clinic, attended neighborhood gatherings, met with civic leaders, and asked community members what they wanted.

“We put on our tennis shoes and we went door to door,” Smiley says. Her team avoided the typical health surveys that focus on disease risk and medical conditions such as asthma or diabetes. Instead they invited residents to discuss all the factors that affected their well-being.

A common concern: the 600 children at C.A. Weis Elementary School.

How does a clinic bill for helping to create jobs, playgrounds, community gardens, or walkable streets?

At that time, Weis was faring no better than its surrounding neighborhood. It had few financial resources, low parent participation, and high principal turnover. During the 2015–16 school year, the state gave Weis an “F” for its student test scores on the Florida Standards Assessment. All the students qualified for free or reduced-price lunch, and many were eligible for a program that sends children home on Fridays with a backpack of food to tide them over for the weekend. According to data collected by the Escambia Clinic, Weis students were more likely to start life in the local neonatal intensive care unit than kids in other ZIP codes, and they missed scheduled medical appointments and visited the local urgent care center at disproportionately high rates.

It is not surprising, then, that Escambia Clinic’s first CCHH partnership was with the Weis School. What may be surprising to outsiders, however, is that their first project was a playground. After all, the standard medical response would be to expand clinic services to at-risk families. But Weis did not have a real playground, nor was there one in the surrounding neighborhood, and this was of paramount concern to everyone.

Smiley acknowledges that there are other projects that might have a more immediate impact on health, but the playground was what the community wanted. “After all,” she adds, “I knew that in the end, everything has to do with health.”

The Escambia Clinic, along with the University of West Florida and The Children’s Home Society, partnered with the school’s newly arrived principal, Holly Magee, and a handful of volunteers to apply for a grant from the local chapter of Impact 100, a women’s charity where members pool their money for a worthy cause.

Weis mom Ashley Parish, who had never spoken publicly, stood up in front of an audience of 400 funders and said: “My kids stay inside. We have no safe place to play.”

Impact 100 awarded them $106,000 to build the playground.

Then something happened that Smiley had not anticipated: Even before the ribbon-cutting ceremony a year ago, the playground triggered a series of events.

“We showed we cared, and it was like all the doors suddenly opened, and everyone was asking us how they could partner with us,” Parish recalls.

The school district offered to maintain the playground. The Children’s Home Society asked Smiley to staff a clinic at the school so that children could easily access medical services. The managers of Oakwood Terrace, a federally subsidized housing project and home to many Weis families, partnered with Escambia Clinic on a series of wellness initiatives to improve living conditions, offer job training, and address issues of food insecurity. Escambia is also in the process of becoming a residency site for obstetrics, internal medicine, and pediatrics, which will expose doctors-in-training to the CCHH model. Finally, as the ultimate recognition of its value, the clinic received more than $8 million, from both federal funds and local investment, to build a new clinic as well as a community center, teaching center, and garden in what is now an abandoned elementary school.

Within Weis big changes have begun to take place, and Principal Magee attributes much of it to the clinic’s involvement. She says that when she arrived, there was a sense of hopelessness but now there is a will to succeed. Parents and neighbors are more involved, teachers want to stay, and all of last year’s first-graders passed the standardized benchmark test. Magee has completed her second school year at Weis and has no plans to move on.

“All this,” says Smiley after listing off the changes happening around her, “is what I would call a Community Centered Health Home.” She pauses.

“Even if I had to pay cash for that playground, it would have been worth it. After all, look at all that it has given us.”

Some 200 miles away, in a baking-hot parking lot in New Orleans, Rosamar Torres opens the side of her mobile vegetable market to display bins of carrots, snap peas, strawberries, and peppers. The market, funded and operated by a nonprofit called Sankofa, makes the rounds of the city and accepts farmers market coupons and cards from nutrition assistance programs such as WIC and SNAP. Seemingly from nowhere, customers, mainly elderly and African American, begin to appear with shopping bags in hand. Soon the truck is mobbed.

Standing nearby are Chenita Le Blanc and Stephenie Marshall, who are spearheading the CCHH project at the Daughters of Charity (DOC) Clinic in New Orleans’ Gentilly neighborhood. Back in the day, Marshall says, when people heard you were from Gentilly they thought you were fancy. That ended with the economic downturn of the 1980s. “My neighborhood began to have the same problems as anywhere,” she said, listing crime, unemployment, and high rates of chronic disease.

When Hurricane Katrina hit more than a decade ago, Gentilly, located next to Lake Pontchartrain, was under water. The facade of almost every house in the neighborhood is still emblazoned with the iconic Katrina “X code,” a spray-painted marking left by first responders to record the level of destruction and the number of people found alive or dead in that home.

Similar to what is taking place in Pensacola, the CCHH experiment has allowed the DOC clinic to become a key player in improving health conditions in the community. Their partnership with the Sankofa mobile market is a good example.

Initially Sankofa’s vegetables were going to waste because no one knew about the mobile market, but DOC solved this by referring patients to Sankofa and handing out coupons.

“They wanted customers, and we had customers,” said Marshall. “And we wanted free [food] for our patients, and they had free.”

Shoppers at the Sankofa Market in New Orleans pick up produce as well as health information from the Daughters of Charity Clinic and its Community-Centered Health Home initiative. YES! Photo by Marc Pagani

The DOC clinic has piggybacked on the efforts of other community organizations — most notably Dillard University — to address issues as diverse as job retraining, fair wages, blocking predatory businesses, and building parks and exercise paths.

Le Blanc and Marshall feel that their clinic for the first time is actively preventing disease. Patients and community now view them more favorably, and medical providers are more interested in being a part of their organization. (The Louisiana Public Health Institute is in the process of studying these outcomes and will publish the data at the end of the two-year period.)

Despite the enthusiasm, everyone I spoke with at LPHI and in the clinics seemed uncertain about how to finance the CCHH model once the funds for the two-year experiment run out.

“We don’t want to start programs we can’t continue in this community. We have 180 years of doing good work,” Michael Griffin, the CEO of Daughters of Charity, says. He points to the ACA’s Community Benefits program, which requires nonprofit hospitals to spend a percentage of their proceeds on the surrounding community, as a possible source of funding. But with Obamacare now in jeopardy, it is unclear whether this funding source will continue. No insurance, public or private, he adds, has agreed to pay doctors and clinics to keep a community healthy.

Insurers are set up to reimburse for discrete services such as a lab test, a surgery, or a clinic visit. The CCHH model is a complex set of partnerships and activities rather than one defined service and therefore hard to bundle under a single billing code. How does a clinic bill for helping to create jobs, playgrounds, community gardens, or walkable streets? The dollars and lives saved by this new approach might not be measureable for decades and, even then, it will be hard to prove what actually made the difference.

But talk to the researchers, administrators, doctors, and community members affiliated with the Gulf States CCHH project, and they will argue that this approach is critical to curb runaway health care expenditures while improving health outcomes for communities like Englewood and Gentilly. Smiley, Baumgartner, Griffin, and others made it clear that health care must impact conditions outside clinic walls in order to close the survival gap between the richest and poorest.

“Business as usual has not worked for us,” Smiley says. “We have to do this work and take a leap of faith because the return will come.”

Perhaps no one was able to describe this potential return more clearly than Ashley Parish, the parent volunteer at Weis who helped Smiley make the funding pitch for the playground structure.

“It’s important for health care to get involved in all kinds of things,” she says. “We want our children to be happy because when you are sad, you get sick, and your blood pressure goes up, and you get diabetes. One day these babies are going to be adults, and they are going to say, We had that playground.”

>Daphne Miller is a practicing family physician, professor, and journalist who examines the links between human health and the health of the natural and built environment. She teaches at the University of California, San Francisco. This article was funded by the Prevention Institute, supported by a grant from The Kresge Foundation. A special thanks to Tiffany Netters, Alex Priebe, and Amy Pruim at Louisiana Public Health Institute for their help with this story.

Books + Film + Music

How to Reinflate the Dream of College-for-All
Financial aid doesn’t work unless we’re honest about costs.

Valerie Schloredt

A college education for anyone willing to work for it: That’s a part of the American Dream many of us grew up accepting as fact. The idea was that financial aid programs, combined with part-time work, would allow low-income students to get a college education. That, in turn, would make a rewarding career and social mobility possible.

Valerie Schloredt lives in Seattle, where she edits all sorts of things and writes about climate activism and social justice.

But the dream of college-for-all has been punctured in the past few decades. We’ve all heard about the rising price of college and ballooning student debt. What too few people understand, says education policy expert Sara Goldrick-Rab, is that the real price of college is much higher than prospective students are led to believe. Our current inaccurate and inadequate financial aid system, she says, “too often leaves low-income students facing unexpected, and sometimes untenable, expenses.”

What that looks like in data, and in the lived experience of 18- and 19-year-olds, is described in Goldrick-Rab’s intensively researched new book, Paying the Price: College Costs, Financial Aid, and the Betrayal of the American Dream. Based on a large-scale research project carried out over six years, the book reveals the many shortcomings of our current financial aid policies. But it also points to solutions — some modest, some radical — all harkening back to the original aims of financial aid: to enable opportunity and promote equality.

Paying the Price: College Costs, Financial Aid, and the Betrayal of the American Dream

Sara Goldrick-Rab, The University of Chicago Press

Goldrick-Rab and her team at the University of Wisconsin began by collecting data from 3,000 new students who had applied for financial aid via the Free Application for Federal Student Aid form and had received Pell Grants (directed at students from low-income households). Focusing in-depth on 50 of these students at Wisconsin’s public colleges and universities, Goldrick-Rab and her team “sought to measure in great detail how financial aid enhanced their progress, and where it fell short.” Their research sketched a picture of an undercut financial aid system that has drifted from its original aims and inadvertently harms the people it was designed to help.

The incoming class she began studying in September 2008 did not know it, writes Goldrick-Rab, but “Wisconsin, like many other states, was in the midst of a long period of reducing support for public higher education.” In 1972, when the federal Pell Grant program was created, Wisconsin invested almost $15 in public higher education per $1,000 of state personal income. But over the next 35 years, the state’s investment was reduced to less than half that amount, and tuition went up. By 2008, affording college in Wisconsin required both working and borrowing, especially for the poorest students.

The rising price of college compared to available grants meant that students in Goldrick-Rab’s study were often hard-pressed to cover tuition. Take the student she calls “Ian,” for example. His single-parent family with five kids earned $25,000 a year, so Ian contributed to meeting his family’s needs with his own wages and practical support as much as he could. The cost of attendance (tuition and living costs) at the public university closest to his home was $17,000 a year. State and federal grants covered $7,000, leaving $10,000 for Ian to pay through part-time work and loans.

Through repeated interviews and home visits, the researchers focused on the impact of similar aid gaps on 50 Wisconsin students who received Pell Grants. “We watched as students came to grips with these financial realities,” writes Goldrick-Rab. “They started with great expectations. Many were disappointed. Half of them left college without achieving their goals. [Fewer] than 1 in 5 who entered a public university finished a bachelor’s degree in four years.”

Being short of money for food and housing and working in low-paying jobs to try to make up the difference meant that some students in the study ended up worse off than if they had never tried for the brass ring of a college degree. Many juggling low-wage jobs with the full-time course load required by financial aid were still unable to meet all their expenses. More than a few came to class exhausted from lack of sleep, or hungry because they could not afford to eat. Two in 5 left their colleges and universities saddled with debt for their first year of school, without an associate’s degree or a certificate of any kind.

Our system has not always been this hard on students in need. Had the 18- and 19- year-olds in the study begun college in 1990, the year they were born, they would have been able to meet their living expenses simply by working part-time, without needing to borrow. In earlier decades we’ve done even better at making college more accessible — think of the free tuition offered to millions of GIs after World War II. Goldrick-Rab provides a long list that reveals how far we are from those enlightened policies, and what we can begin tackling to do better in the future.

Goldrick-Rab argues that we need a new system, “a Financial Aid 2.0 that is based on accessible and affordable high-quality public higher education.” Rather than offering more financial aid to keep up with rising prices, this future system would make the first few years of college, or the initial degree, free.

Whatever the current political impediments to policy reform, it is fundamental to a more equal society, and worth fighting for. Her recommendations, if implemented, would make college more affordable for all, first by targeting the hardship imposed on those in greatest need. For example, people living on the edge of poverty need a break, so financial aid calculations should not expect households earning $30,000 or less to contribute to the cost of college. It would make a difference if financial aid officers informed students of food programs like SNAP and WIC, and if college enrollment counted toward the work requirement for food stamps. And the free-lunch program in schools should be extended to public colleges and universities.

Student employment could be supported by a higher income-protection allowance for taxes on students’ earnings. Funding for the federal Work-Study program, currently concentrated at the oldest and wealthiest universities frequented by better-off students, should be redirected to institutions where it would reach more students who really need to work.

More than a hundred emergency aid programs are already operating nationwide, some supported by individual colleges and universities and some by independent nonprofits. One of the most effective ways to get emergency funds to students who need them is simply to make college faculty a point of access. Students may go to a trusted professor before they go to a university administrator’s office. It might seem surprising that a policy expert like Goldrick-Rab advocates small-scale emergency aid programs, but she is foremost a champion of students for whom a windfall of $1,500 can make all the difference.

Some fixes can be easily made by states, colleges themselves, or by private institutions. Tuition and other costs rise every few years, so states should work with public colleges and universities to provide students with a road map of the real price of attendance over four years.

Ultimately, though, Goldrick-Rab argues that we need a new system, “a Financial Aid 2.0 that is based on accessible and affordable high-quality public higher education.” Rather than offering more financial aid to keep up with rising prices, this future system would make the first few years of college, or the initial degree, free.

Tennessee already offers tuition-free community college to all, and other states are considering similar programs, so this final recommendation provides a glimmer of hope that investing in our own young people is something a divided nation might eventually agree on. Paying the Price is an invaluable resource, chock-full of data and empathy, to bring to that effort.

Valerie Schloredt lives in Seattle, where she edits all sorts of things and writes about climate activism and social justice.

Books + Film + Music

What Inspires Seed Saviors Like Us?
More than 90 percent of our food plant varieties are gone.

Doug Pibel

photo Courtesy of Collective Eye Films

As I was writing this I got my Seed Savers Exchange catalog, which comes to me annually out of Decorah, Iowa. Seed Savers is one of the stars of Seed: The Untold Story. If you’ve not heard of them — or of the idea of saving heirloom seeds — I’ll not be surprised. There aren’t that many of us growing our own vegetable seeds. If you’re already a seed saver, this is a swell movie about our people. If you’re not, it will tell you why you might want to join us.

Doug Pibel is a freelance editor and former YES! managing editor who lives in the Pacific Northwest.

I know about these things because of Mary Schultz, who was lettuce curator for Seed Savers when I met her (nearly 25 years ago). She showed up at my office and commanded I appear at her garden outside Monroe, Washington. She had 300-plus varieties of lettuce that she grew out on a three-year rotation, 100 a year. For a few years I helped set out a thousand or so lettuce starts (multiples of each kind to keep up genetic variety) on whatever acre or two Mary rented that year, in addition to 80 or so varieties of potatoes, a slew of beans, and vegetables for market. Since then, I’ve saved some sort of seeds most every year. This year I grew and saved three kinds of beans, six varieties of potato, and five garlics.

Seed: The Untold Story

Directed by Taggart Siegel & Jon Betz, 2016, 94 min.

But why bother to save seeds at all? As you’ll see in this movie, seeds are history and heritage, seeds are insurance and power. Most of all: no seeds, no food.

For the first several thousand years of agriculture — until a century or two ago — seed savers were called something else: farmers and gardeners. In many places, they still are. You didn’t buy your seeds; you grew enough to eat or sell, and enough more to plant next year and maybe extras to swap with your neighbors. With dry corn and beans, what you eat is the same thing you plant. You can save seeds right out of the tomatoes that you eat; same for winter squash and melons. For most other plants, you let the plant grow — it will flower and, when the flowers dry out, you’ll have seeds. All those farmers and gardeners ended up with plant varieties adapted for local growing conditions or that had desirable characteristics — color, flavor, long storage. That’s why Mary had 300 lettuces. That’s why Seed Savers has 1,186 different kinds of beans collected by one guy, John Withee.

But, Seed: The Untold Story tells us, the last time the U.S. government studied seed diversity, in 1983, it found available just 28 varieties of cabbage, down from a historical tally of 544. For cauliflower, it was nine left of 158. Beets, 17 of 288; rutabaga, three of 55; artichoke, two of 34.

That happened because, as agriculture got mechanized, and farms got bigger, and packers required uniform produce, farmers started buying seeds. It saved time and effort and produced what the market demanded. In the case of corn and many vegetables, seed companies developed hybrid seeds that were pushed as bigger and better. But you can’t save seeds from hybrid crops. They don’t grow the same stuff. As environmental lawyer Claire Hope Cummings says in the movie, “Hybrid corn was the atom bomb of agriculture.”

And now the problem is patented biotech seed. If you save patented seed, you’re in line to get sued. A fair chunk of the movie focuses on Vandana Shiva’s work in India, where, she tells us, Monsanto has made an aggressive push to get farmers off traditional seeds and on the genetically engineered ones they have to buy each year — with disastrous consequences, including debt-induced farmer suicides.

As a result of the commercialization of seed, we’ve lost more than 90 percent of our food plant varieties. But there’s a coterie of people who aim to hold the line on that, and we meet them in Seed: the Hopi farmers and people from Tesuque Pueblo in New Mexico who are preserving the heritage represented by their corn and other heritage seeds; Will Bonsall, an old hippie who grows 2,000 plant varieties in Maine; the swashbuckling Simcox brothers, who travel the world in search of new varieties; and a large cast of others.

As Bill McDormand, of Native Seeds/SEARCH, says, “We just don’t have the time left on this small planet to recreate this stuff. Once it’s gone, it’s gone.”

And the thing is, we don’t know which one of those varieties has resistance to the next plant disease or which one will thrive as the climate changes. Every one contains genetic information that goes back to the beginning; each has some unique twist. Every time we lose a variety, we’ve lost that uniqueness forever.

Here’s where you come in. Watch this movie to get inspired about saving seeds. And then do it. If you don’t have a garden, all you need is a pot big enough to grow a tomato plant or some beans or whatever you decide to plant. Seed Savers curates 24,000 varieties. Adopt one of those, or one from somewhere else, and grow it. Save seeds and share them. Your variety might be the one that we really need in the future. And if it’s not, you’ve still got some cool beans.

Doug Pibel is a freelance editor and former YES! managing editor who lives in the Pacific Northwest.

Books + Film + Music

Films Inspiring Us

Kim Eckart

Minimalism: A Documentary About the Important Things

2016, 79 minutes, Directed by Matt D’Avella

While in his 20s, Joshua Fields Millburn faced a trio of challenges: the death of his mother, divorce, and a deep dissatisfaction with his high-paying job. He decided to limit himself to only those things that served a purpose, hoping to find more meaning in life (“Love people, use things, because the opposite never works,” he says). His longtime friend Ryan Nicodemus joined him in an easygoing embrace of a “minimalist” philosophy, eventually resulting in the recent book tour that this film follows. YES! readers will spot familiar names and faces, as Colin Beavan, Colin Wright, and others appear on camera to endorse simple and sustainable living.

Incarcerating US

2016, 84 minutes, Directed by Regan Hines

America’s state and federal prison population has soared in recent decades, from about 320,000 in 1980 to more than 1.5 million today. Incarcerating US dates the problem to the war on drugs and the establishment of mandatory minimum sentences. Statistics, law enforcement agents-turned-inmate advocates, and two especially sympathetic ex-offenders make the case for fairer sentencing laws, as well as the importance of job and educational opportunities once an inmate is freed. “The collateral consequences of somebody’s incarceration affects …the whole community,” one volunteer says early in the film. “It affects you as an individual … And whether you know that person or not that’s incarcerated, you’re paying for them. You should care.”

Yes! But How?

DIY Ways to Live SustainablyNature’s
Old-fashioned Weather Report

Research and illustrations by Lydia Cain

In an age where the weather app is a tap away, we don’t need to look far for a forecast. But what if you don’t have internet? As you head out into spring, try it the old-fashioned way. Here are five hints from nature to help you decide whether to plan a picnic.

Closed in the Morning, It'll Be Pouring

Dandelion flowers close nightly, but if they’re still shut in the morning, rain is on its way. Many different flora have evolved to protect themselves against the detrimental effects of wet weather, which can wash away pollen and dilute nectar. Tulips are also known for this trait.

Open Pine, Weather's Fine

Curious about humidity? Pine cones are one of Mother Nature’s most reliable hygrometers. Pine seeds travel by wind, so on days when weather is damp or rainy, cones will keep their seeds sealed inside. Once the air dries out, cone scales shrink and open, allowing seeds to escape with the breeze. If you’re unsure of whether to bring an umbrella, check the cones.

Favored Least is Wind from the East

The winds bring all sorts of different weather across our paths. However, wind from the east is a tell-tale sign of unsettled weather to come. The wind pattern around a low-pressure system, which brings stormy weather, is always counter-clockwise in the northern hemisphere. In North America, most of our weather systems travel west to northeast thanks to prevailing winds. As the low forges forward, the counter-clockwise wind that precedes it arrives from the east, meaning the so-called bad weather is still to come. That’s why a developing east wind is a pretty sure sign that unsettled weather is on the way.

When Chimney Smoke Decends, the Nice Weather Ends

Chimney smoke that slides from the roof to the ground is indicative of wet weather coming. Moisture in the air preceding a storm clings to smoke particles, weighing them down and causing them to sink instead of rise.

Clear Moon, Frost Soon

If you have a clear view of the winter moon at night, you can expect a brisk morning to follow. Without cloud cover to insulate the air, the Earth’s heat rises, which causes surface temperatures to plummet. This quick drop often yields a blanket of frost the next day.

Commentary

Revolution or Evolution? How the Democratic Party Can Survive Trump

Sarah van Gelder

With the attention of the nation riveted on the Trump train wreck and on the historic women’s march, one lesson of this moment is getting lost: The Democratic Party lost an election to one of the most unstable, lewd, and unqualified candidates ever to run for office.

Sarah van Gelder is co-founder and editor at large of YES! Magazine. Her new book, The Revolution Where You Live: Stories From a 12,000-Mile Journey Through a New America, tells more stories of local power.

If we are to get through this presidency without terrible damage to our country, ending it and its policies as quickly as possible, we will need a new direction from the Democratic Party.

The four months I spent on the road, mainly in “red states” collecting stories for The Revolution Where You Live (Berrett Koehler, 2017), convinced me that the Democratic Party is out of touch with the pain many Americans experience. I visited small towns hollowed out by joblessness and big-box stores and urban neighborhoods where unemployment has been in double digits for generations. African American families have been especially hit hard—the wealth gap between White and Black families, which was already large, doubled with the 2008 recession.

For years, the Democratic Party chose to overlook these tough realities: Wages are low and stagnant. Jobs are outsourced. Drug prices and insurance premiums rise, and students take on a lifetime of debt just to have a shot at a decent job. Wall Street banks get bailed out when risky bets fail, and millions of ordinary Americans are punished with job losses and foreclosures for a financial crisis they didn’t cause. Meanwhile, virtually all the wealth generated by a recovering economy goes to the top 1 percent. The severe inequality that results from these lopsided policies fuels frustration and the nihilism that led to the election of Donald Trump.

The Democratic Party has fallen short by not taking on the structural causes of this crisis: an economy that favors big corporations and global capitalism. The party also has failed to step up to the climate crisis, which requires a radically different sort of economic recovery, and to the crisis of racial exclusion.

So what to do now?

If the Democratic Party is to retake government, it will need to do more than be the party that isn’t as bad as Trump. It will need to find the courage to stand up for ordinary people, which means standing up to Wall Street and global corporations.

The party should support a revived locally rooted economy—one that supports and trains homegrown entrepreneurs and invests in local business. The party needs to close the wealth gap among races and bring everyone up, not support more ways for the 1 percent to continue to accumulate virtually all the benefits of economic growth. It needs fresh, new, pragmatic approaches, like a guaranteed minimum income, single-payer health care, and a massive investment in renewables and efficient transportation, which will create jobs while reducing greenhouse gas pollution. Standing up to the fossil fuel industry is a tough ask, but a majority of Americans support investing in renewables.

The form of isolationism advocated by Trump is misguided. But he’s tapped into a very real frustration with un-ending wars and the taxpayer-funded military-industrial complex. If the Democratic Party is to be relevant, it will need to be the party that can make peace.

Can Democrats stand up to Wall Street and global corporations? They will need to if they wish to be relevant. And polls show there is a lot of support; a majority of people under 50 do not support capitalism.

The Democratic Party has a lot going for it. Trump has historically low approval ratings, and the election has woken up many Americans. On Jan. 21, millions participated in women’s marches in more than 300 U.S. towns and cities, from Moose Pass, Alaska, to Los Angeles, Houston, and Washington, D.C. People are ready for real answers. If the Democratic Party can put women and men of all races and religions first, not global corporations, it might be able to earn the trust and enthusiasm of the American people in time to win big in the 2018 midterm elections.

Sarah van Gelder is co-founder and editor at large of YES! Magazine. Her new book, The Revolution Where You Live: Stories From a 12,000-Mile Journey Through a New America, tells more stories of local power.